Bupropion is a medication used to treat depression that was first approved for use in the US in 1985.¹ It may also be prescribed to help people stop smoking.
The drug belongs to a class of medications called antidepressants and works by changing the levels of some chemicals in the brain, including serotonin and norepinephrine. These chemicals are thought to be involved in mood regulation.
Bupropion is available as a tablet, an extended-release tablet, and an extended-release suspension.
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Bupropion is primarily used to treat depression² and seasonal affective disorder (SAD).² It can also be used off-label to help people quit smoking.
Bupropion belongs to a class of medications called antidepressants and works by affecting certain chemicals in the brain that may become unbalanced in people with depression or anxiety disorders. The drug may help improve symptoms by re-balancing these chemicals.
Bupropion comes in two forms:¹ immediate-release and extended-release.
The immediate-release tablet is taken twice a day, while the extended-release tablet is taken once a day.
You can take bupropion with or without food.
Swallow the pill whole; don’t crush, chew, or break it into pieces. You can ask your doctor to prescribe bupropion in liquid form if you have trouble swallowing pills.
It takes time for bupropion to start working — usually around two weeks. However, it may take up to four weeks for you to feel the medication’s full effects.
Continue taking bupropion even if you don't feel a difference immediately, and don’t stop taking the drug without talking to your doctor first, as this can cause withdrawal symptoms.
The most common side effects of bupropion include:
Dry mouth
Nausea/vomiting
Headache
These side effects are usually mild and may go away on their own after a few weeks. Speak to your doctor if they persist or become bothersome.
Serious side effects are rare but can include:
Seizures
Hallucinations
Agitation, restlessness, and irritability
Stop taking bupropion and call your doctor immediately if you experience any severe side effects.
Bupropion may also cause a condition called hypomania, which is characterized by:
Increased energy/activity levels
Excessive talking
Racing thoughts
Impulsiveness
Recklessness
Talk to your doctor if you experience any of these symptoms — they may need to adjust your dosage or advise you to stop taking bupropion altogether.
Bupropion is generally safe for most people to take, but it’s not suitable for everyone.
The drug might not be suitable if you have:
A history of seizures or head injuries (bupropion may increase your risk of seizures)
An eating disorder (bupropion can cause increased weight loss)
Bipolar disorder (bupropion can cause mania)
Bupropion might not be suitable for you if you’re pregnant. There is not enough research on the effects of bupropion on pregnant women, so medical professionals don’t generally recommend it unless necessary.
Talk to your doctor before taking bupropion if you have any of these conditions or if you’re pregnant. They can discuss the potential benefits and side effects with you, and tell you if the medication is unsafe. They may be able to suggest an alternative treatment plan if you can’t take bupropion.
Bupropion can be effective when taken long-term,³ but you should talk to your doctor about any possible risks and side effects.
Some people have reported feeling agitated or having trouble sleeping when taking bupropion for an extended time. Long-term bupropion use may also increase your risk of seizures, so you should be aware of this potential risk and report any symptoms to your doctor immediately.
Overall, bupropion can be a safe and effective medication for long-term use, and your doctor can discuss the possible risks and side effects with you.
If you forget to take a dose of bupropion, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at once to make up for a dose you missed.
It’s possible to take an overdose of bupropion, and it can cause seizures, coma, or death in rare cases.
Seek medical help immediately if you think you or someone else has taken too much bupropion.
You should always speak to your doctor before taking any new medication, including bupropion.
Before taking bupropion, tell your doctor if:
You have ever had an allergic reaction to bupropion or any other medication
You have any medical conditions that could be affected by bupropion, such as seizures, eating disorders, or bipolar disorder
You are pregnant or breastfeeding
Stopping bupropion abruptly can cause withdrawal symptoms, but reducing your dosage gradually can lower your risk.
Withdrawal symptoms may include:
Irritability
Anxiety
Trouble sleeping
Talk to your doctor if you have any withdrawal symptoms as they can give you advice on how to manage them.
Bupropion is classified as a category C pregnancy drug.⁴ This means:
Animal studies have demonstrated that taking this medication while pregnant may harm the fetus.
There are not sufficient human studies to determine how medicine impacts a fetus.
Tell your doctor if you are pregnant or plan to become pregnant. This medication should be taken only when the possible benefit outweighs the potential dangers.
If you become pregnant while using this medication, immediately contact your doctor.
This medication enters breast milk, which may negatively affect your baby. Ask your doctor whether you should continue breastfeeding while taking bupropion. You may need to choose between stopping nursing and stopping or changing your medication.
Bupropion is known to interact with several other drugs. Some interactions can be dangerous, so your doctor or pharmacist should be aware of what you’re taking before prescribing bupropion.
Tell your doctor if you are taking:
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)
Anti-anxiety medication, such as benzodiazepines
Seizure medication
Diabetes medication
Oral hormonal contraceptives
This is not an exhaustive list of medications that can interact with bupropion, so tell your doctor about any medications you are taking, including vitamins and supplements.
Bupropion can also interact with certain foods and drinks. For example, drinking alcohol while taking bupropion can increase your risk of seizures. Caffeine can also interfere with how bupropion is absorbed, so it's best to avoid it while taking this medication.
Grapefruit juice can increase the level of bupropion in your blood, so you should avoid it while taking this drug to prevent serious complications.
Do not take this drug if you are allergic to bupropion or any of its ingredients.
Symptoms of an allergic reaction may include:
Rash
Hives
Itching
Difficulty breathing
Swelling of the face, lips, tongue, or throat
Seek medical attention immediately if you develop any of these symptoms.
Bupropion was first approved in 1985 and has been sold in the US since 1989.⁵ It was first sold in immediate-release form to be taken three times daily, then twice-daily sustained-release, and finally, once-daily extended-release in August 2003.
Many double-blind controlled trials have shown the drug can effectively treat depression. For example, when compared to a placebo in 75 patients,⁶ bupropion was found to be much more efficient at treating symptoms of depression and anxiety.
Various studies and meta-analyses have also found that bupropion is equally or more effective than other antidepressants (including SSRIs and TCAs),⁷ and treatment has been well-tolerated.
The drug has also been studied for helping people stop smoking. A randomized, controlled trial⁸ found that bupropion reduced smoking relapse.
Here are some tips and advice for taking bupropion safely:
Take bupropion with food.
Don’t stop bupropion treatment without talking to your doctor first.
Do not drink alcohol while taking bupropion.
Bupropion may harm your baby if you are pregnant or breastfeeding. Consult your doctor if you are pregnant, breastfeeding, or plan to become pregnant while taking this drug.
Talk to your doctor if you have any side effects that worsen or continue.
Sources
Bupropion | StatPearls
Bupropion in the treatment of major depressive disorder in real-life practice (2011)
Over-the-counter medications in pregnancy | American Family Physician
15 years of clinical experience with bupropion HCl: From bupropion to bupropion SR to bupropion XL (2005)
A multicenter evaluation of bupropion versus placebo in hospitalized depressed patients (1983)
Other sources:
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Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.
However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.
It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.
Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.
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